The fundal cerebrospinal fluid (CSF) cap is a radiological finding correlating to a pocket of CSF lateral to vestibular schwannomas in the fundus of the internal acoustic meatus. Its presence may increase the likelihood of good facial nerve outcome and hearing preservation after microsurgical resection. A systematic review of the literature was performed....
Neurosurgeons and skull-base teams performing retrosigmoid approach for vestibular schwannoma may use the fundal CSF cap on pre-operative MRI as a prognostic indicator for hearing and facial nerve outcomes, pending full review of the paper's sensitivity and specificity data.
A reliable pre-operative imaging predictor of post-surgical hearing and facial nerve outcomes would improve surgical planning and patient counselling for vestibular schwannoma, directly impacting audiological rehabilitation planning.
- 01Fundal CSF (fluid) cap on pre-op MRI evaluated as a predictor of post-surgical outcomes in vestibular schwannoma.
- 02Study focuses on retrosigmoid surgical approach — one of the main routes for vestibular schwannoma removal.
- 03Outcomes measured include residual hearing and facial nerve function post-surgery.
- 04A positive imaging predictor could help surgeons select candidates for hearing-preservation approaches.
- 05Published in Neurosurgical Review; relevant to skull-base and neurotology multidisciplinary teams.
The fundal cerebrospinal fluid cap on pre-operative MRI is a predictor of hearing and facial nerve outcomes after retrosigmoid surgery for vestibular schwannoma.
studypartially supported- PMID
- 42067635
- DOI
- 10.1007/s10143-026-04305-x.
- Journal
- Neurosurgical Review
- Publication type
- research_article
- Evidence level
- 4
- Population
- Patients undergoing retrosigmoid surgery for vestibular schwannoma
- Intervention
- Pre-operative MRI assessment of fundal CSF cap
- Comparator
- Patients without a fundal CSF cap on MRI
Primary outcomes
Post-operative hearing preservation; Post-operative facial nerve function